<div class="dialog-box dialog-box-form">
    <form class="dialog-content" action="">
        <div class="dialog-head">
            <a class="dialog-close-btn" href="javascript:;">×</a>
            <h4 class="dialog-title">商家审核</h4>
        </div>
        <div class="dialog-body">
            <div class="form-body">
                <div class="glb-col-p65">
                    <div class="form-item">
                        <h6 class="form-label">商家名称 :</h6>
                        <div class="form-entity">
                            <div class="form-field">
                                <p class="form-text">大润发超市</p>
                            </div>
                        </div>
                    </div>
                    <div class="form-item">
                        <h6 class="form-label">联系人/电话 :</h6>
                        <div class="form-entity">
                            <div class="form-field">
                                <p class="form-text">张三/1379809898</p>
                            </div>
                        </div>
                    </div>
                    <div class="form-item">
                        <h6 class="form-label">地址 :</h6>
                        <div class="form-entity">
                            <div class="form-field">
                                <p class="form-text">吉林省长春市朝阳区工农大路</p>
                            </div>
                        </div>
                    </div>
                    <div class="form-item">
                        <h6 class="form-label">商家证件号 :</h6>
                        <div class="form-entity">
                            <div class="form-field">
                                <p class="form-text">1234567-9</p>
                            </div>
                        </div>
                    </div>
                    <div class="form-item">
                        <h6 class="form-label">法人/电话 :</h6>
                        <div class="form-entity">
                            <div class="form-field">
                                <p class="form-text">张三/1379809898</p>
                            </div>
                        </div>
                    </div>
                    <div class="form-item">
                        <h6 class="form-label">法人身份证号 :</h6>
                        <div class="form-entity">
                            <div class="form-field">
                                <p class="form-text">211140197609383333</p>
                            </div>
                        </div>
                    </div>
                    <div class="form-item">
                        <h6 class="form-label">备注 :</h6>
                        <div class="form-entity">
                            <div class="form-field">
                                <textarea class="form-ta" name="remark" placeholder="拒绝请填写原因"></textarea>
                            </div>
                        </div>
                    </div>
                </div>
                <div class="glb-col-p35">
                    <div class="form-item form-item-qt">
                        <div class="form-label">企业证件照 :</div>
                        <div class="form-entity">
                            <div class="form-field">
                                <a href="http://r4.ykimg.com/05140000576CA32E67BC3C13B50E4C6F" title="点击查看企业证件照" target="_blank">
                                    <img src="http://r4.ykimg.com/05140000576CA32E67BC3C13B50E4C6F" />
                                </a>
                            </div>
                        </div>
                    </div>
                    <div class="form-item form-item-qt">
                        <div class="form-label">法人证件照:</div>
                        <div class="form-entity">
                            <div class="form-field">
                                <a href="http://r4.ykimg.com/05140000576CA32E67BC3C13B50E4C6F" title="点击查看法人证件照" target="_blank">
                                    <img src="http://r4.ykimg.com/05140000576CA32E67BC3C13B50E4C6F" />
                                </a>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>
        <div class="dialog-foot">
            <a href="javascript:;" class="glb-button glb-btn-primary">通过</a>
            <a href="javascript:;" class="glb-button glb-btn-default">拒绝</a>
        </div>
    </form>
</div>